1서울대학교 의과대학 외과학교실 2서울대학교병원 외과 서울대학교 암병원 갑상선센터, 서울대학교 의과대학 암연구소 3서울대학교 의과대학 외과학교실, 보라매병원
The Postoperative Outcomes of Patients with Primary, Secondary and Tertiary
Hyperparathyroidism : 14 Year Experience of Seoul National University Hospital
1Department of Surgery, Seoul National University College of Medicine 2Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Thyroid Center, Seoul National University Cancer Hospital 3Department of Surgery, Seoul National University College of Medicine, Boramae Medical Center
Purpose : Primary hyperparathyroidism(PHPT), secondary hyperparathyroidism(SHPT) and tertiary
hyperparathyroidism(THPT) are different in the cause, treatment and prognosis. However the parathyroidectomy
has been an efficient treatment in all hyperparathyroidism groups. A single institution`s 14 year experience of
surgical treatment was analyzed to investigate perioperative changes of clinical characteristics and reconsider the
value of parathyroidectomy as the treatment option.
Materials and Methods : From 1996 to 2009, 126 patients underwent parathyroidectomy at single institute and the
number of patients with PHPT, SHPT and THPT were 96, 24 and 6 retrospectively. The electronic medical records of
age, sex, biochemical analysis, operative method, and pathologic results were reviewed retrospectively.
Results : Postoperative calcium (Ca), parathyroid hormone (PTH), ionized calcium (iCa) levels were improved
definitely than preoperative Ca, PTH, iCa level in all three groups. Pre and postoperative PTH level in SHPT was
higher than in PHPT and THPT(p< 0.001, p= 0.036) and postoperative persistent PTH increased status were more
common in SHPT.(30.4%, p< 0.001) Postoperative temporary hypocalcemia was more common in SHPT(87.5%, p<
0.001), almost of them (90.4%) were recovered in 6 month. In SHPT group, temporary hypocalcemia were more
common in subtotal or total parathyroidectomy group than in limited resection group (94.1%) but persistent iPTH
increase were more common in limited resection group (50%). .
Conclusion : Parathyroidectomy is highly recommended to improve biochemical laboratory findings in patients
with hyperparathyroidism. And in SHPT, subtotal or total parathyroidectomy is more appropriate surgical method
for reducing the high incidence of persistent hyperparathyroidism.
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